Everything you need to know about prenatal vitamins

While most health and nutrition experts believe that taking a multivitamin is a waste of time and money for most people, one important exception is for women who are or are planning to become pregnant.

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Healthy eating is always important for the health and development of both mother and baby, of course. But diet alone does not always provide enough of certain nutrients that a successful pregnancy needs. Taking a vitamin specifically tailored to the needs of pregnancy, under the supervision of a doctor, is almost always a good idea.

“The goal is to balance getting enough nutrients to support the growth of your fetus and the maintenance of a healthy weight,” says Dr. Mazen Fouany, obstetrician-gynecologist at White Plains Hospital Physician Associates at White Plains. , New York.

Why is food sometimes not enough?

Pregnancy is a time of intense fetal growth and development, as well as maternal physiological changes. “Adequate intake of macronutrients and micronutrients during pregnancy promotes these processes, while undernutrition and over-nutrition may be associated with adverse pregnancy outcomes. Therefore, it is important to assess, monitor and, if necessary, make changes to improve maternal nutrition before and during pregnancy, ”says Fouany.

Women who regularly eat three meals a day that include multiple servings of a variety of vegetables, fruits, whole grains, low-fat dairy products, and protein are likely to meet the recommended daily allowances for most nutrients, Fouany says. However, even food choices and nutrient-dense diets, such as those from the United States Department of Agriculture, may not meet nutritional goals for iron, vitamin D, and choline during pregnancy. pregnant or hoping to conceive, prenatal vitamins can help fill the gaps.

For example, the typical diet contains around 100 micrograms of iodine. “We recommend 220 during pregnancy, so it’s very difficult to get double the amount in the diet,” says Dr. Scott Sullivan, OB-GYN specializing in Maternal and Fetal Medicine and Associate Professor at the University of Caroline from the south. Plus, common pregnancy issues like nausea, heartburn, and poor appetite can bother you. “Women don’t eat three giant meals a day because they don’t want to,” he says. “They need consistency throughout the nine months of pregnancy,” which is where vitamins can help.

When should you take a prenatal vitamin?

Prenatal vitamins are specially formulated for pregnant women to give their bodies the vitamins and minerals necessary for a healthy pregnancy. One of these vitamins, called folic acid or folate, should be taken well before any planned pregnancy.

Folic acid can prevent birth defects that affect the baby’s brain and spinal cord. These so-called neural tube defects develop early in pregnancy, before many women know they are pregnant. Fouany says half of all pregnancies are unplanned; “That’s why doctors recommend that any woman who could become pregnant take 400 micrograms of folic acid per day, starting before conception and continuing through the first 12 weeks of pregnancy.”

During pregnancy, every vitamin and nutrient plays a role in the baby’s development. Iron, for example, is used to build the baby’s placenta and blood supply. Calcium goes to bone formation. “You can go down the list of nutrients, and each one has a purpose,” Sullivan says.

Does Every Pregnant Woman Need a Vitamin?

Yes, with a few precautions. During pregnancy, the growing baby receives all the necessary nutrients from the mother. “So you might need more during pregnancy than before. Vitamins and minerals play an important role in all the functions of your body. Eating healthy foods and taking a prenatal vitamin every day should provide all the vitamins and minerals you need during pregnancy, ”says Fouany.

What should a prenatal vitamin contain?

Fouany says that at a minimum, the daily supplement should contain key vitamins and minerals that are often not satisfied by diet alone, such as:

  • The iron: 27 milligrams.
  • Calcium: 1000 mg.
  • Folate: at least 0.4 mg (0.6 mg in the second and third trimesters).
  • Iodine: 150 mcg.
  • Vitamin D: 200 to 600 international units.

“In addition to these key ingredients, pregnant women should get sufficient amounts of vitamins A, E, C, B and zinc,” says Fouany. Work with your doctor or a registered dietitian to assess your diet and supplement needs.

What precautions should women take?

Some vitamins can be toxic to mom, baby, or both if you take too much:

  • Vitamin A. Excessive amounts of vitamin A can cause birth defects in the fetal skull, face, limbs, eyes, and central nervous system. “Pregnant women should avoid multivitamins or prenatal supplements containing more than 5,000 international units of vitamin A,” Fouany said. Doses above 10,000 international units per day appear to be the most likely to cause defects.
  • The iron. Too much iron, from a prenatal vitamin or a separate iron supplement, can cause iron blood levels to rise excessively, which can lead to blood and gastrointestinal problems for both mother and baby. Try not to exceed 45 milligrams of iron per day.

Also be careful when buying prenatal vitamins – or vitamins, for that matter. “A lot of patients find this surprising, but the vitamins are largely unregulated,” says Sullivan. “Many contain plastic and lead. Many are mislabeled. I tell people to be careful and generally recommend sticking to well-known brands with an established reputation.

Sullivan also suggests discussing vitamin options with your doctor before purchasing them, or bringing the previously purchased bottle for the doctor to review. And if the mother’s insurance covers it, the doctor can write a prescription for a prenatal vitamin that may be both cheaper and of better quality, Sullivan says.

Should we continue with prenatal vitamins after childbirth?

Yes. “It is recommended to continue the vitamins after childbirth, especially if the mother is breastfeeding or has a vitamin deficiency, a vegetarian diet or lives in an area where vitamin D deficiency is common due to lack of sunlight,” explains Fouany.

Sullivan recommends that non-breastfeeding women continue to take their prenatal vitamins for six to 12 weeks after childbirth. Those who are breastfeeding should continue until they stop breastfeeding, he says.

Patricia J. Callender

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